Shoulder Revision 9 shoulder surgeries and counting? I'm only 46

[OutOfTheBlue]

I've had shoulder troubles since 1989 when I had a sport injury. I've had nine surgeries on my shoulder, the last of which was a reverse total shoulder revision in Dec 2021. Things were going well until about 4 months post-op. Pain returned and I lost all range of motion that I had gained. Pain and limited motion make it impossible for me to do laundry, put away dishes, make the beds, or reach the steering wheel of my car. All of which I was able to do 3 months post-op.

I had a CT scan this week that showed:
"Severe atrophy and grade 4 fatty demonstration subscapularis musculature. Mild atrophy of the supraspinatus and infraspinatus musculature.

"Grade 4 fatty infiltration and severe atrophy of the anterior and middle bundle the deltoid noted. No significant fatty infiltration of the pectoralis musculature."

Does anyone know what this means from a functionality standpoint? I see my orthopedic surgeon on Monday, but he's never been one for taking the time to explain things. I tried to find a different surgeon, but nobody wants to take on my shoulder. I get it.

I've never met or heard of anyone who's had this many surgeries on the same joint as young as me. I'm 46. If there are any out there, is there any hope for me? I have three children who are 14, 12, and nine. I would like to be able to play with them again.

I look up things in the medical literature and none of it applies to someone with so many prior surgeries. I'm so confused and depressed. I'd love to know I'm not alone.

EDIT: I put an incorrect year in my signature. I'm fixing it, but I don't know if it'll fix on here.

 

[Pumpkin]

@OutOfTheBlue
Welcome to BoneSmart!
Just let us know the correct years of your procedures and staff will update it for you.

"Grade 4 fatty infiltration and severe atrophy of the anterior and middle bundle the deltoid noted. No significant fatty infiltration of the pectoralis musculature."

It means that you have lost muscle mass and fat has taken up the spaces left behind.
After reverse shoulder surgery the deltoid takes over much of the function of the rotator cuff. My best guess is with a weak deltoid, pressure is put on the replacement parts, and may be causing some of the problems you are having.

Be sure to ask you surgeon directly about the meaning of the fatty infiltration and how it impacts your TSR.

You may want to seek a referral to a large research University such as Duke for a second opinion about your shoulder.

Hospital for Special Surgery (HSS) in NYC does remote consultations, you will have to pay up front out of pocket. They will want your x rays, any other imaging, surgical report etc. A group of specialists then meet and discuss your case, and let you know what they find.

Usually other surgeons will not see you until a year has passed, but there are exceptions. I was able to obtain second opinions for my knee at about 8 months. Keep trying until you find someone, you may have to travel.

For your second opinion you will want someone specializing in complex joint reconstruction, who has no relationship with your present surgeon, including golf buddies.

Staff who has had shoulder replacements will be along soon, they may be able to give your additional advice.

 

[OutOfTheBlue]

I was able to fix it! I had initially written that I had my most recent surgery in 2020 instead of 2021.